FAGA (Female AGA)
We have introduced a minoxidil formulation for female pattern hair loss (FPHL) in addition to finasteride, dutasteride, and minoxidil for androgenetic alopecia (AGA) treatment!
Many women suffer from hair loss, particularly female androgenetic alopecia (FAGA), which can be treated or prevented with topical or oral medications.
We are also always available for consultations on hair loss for those using hormone medications.
Immediate in-hospital prescription of AGA medications available.
For those using our teleprescription of PrEP/PEP, we can also ship AGA medications simultaneously.
For more information on AGA medications for men, please click on the link below.
Summary
– Female pattern hair loss (FPHL) is a general term for hair loss in women, and among them, FAGA (female androgenetic alopecia) can be treated with medications like minoxidil and spironolactone.
– FAGA refers to hair loss that occurs due to a decrease in female hormones and an increase in male hormones, and it can affect any woman.
– At our clinic, AGA medications can be prescribed at your very visit. Also, for those using our teleprescription of PrEP/PEP, we can also ship AGA medications simultaneously.
– AGA medications are also effective for hair loss in transgender individuals undergoing hormone therapy.
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What is Female Pattern Hair Loss (FPHL)?
FPHL is a term that encompasses all types of hair loss experienced by women.
FPHL includes conditions such as FAGA (female androgenetic alopecia), alopecia areata, traction alopecia, postpartum alopecia, and hair loss due to scalp issues, each requiring different treatments.
FPHL refers to overall hair loss in women, while FAGA specifically refers to hair loss that occurs due to a decrease in female hormones and an increase in male hormones. Medications like minoxidil and spironolactone are effective for treating FAGA.
Recently, there has been increased attention on treating and preventing FAGA with oral and topical medications, and we can prescribe medications immediately at our clinic.
The Four Types of FPHL and Their Treatments
FPHL can be classified into four main types, with FAGA (Female Androgenetic Alopecia) being the most common.
Female Androgenetic Alopecia (FAGA)
While AGA is well-known in men, it is also known to occur in women.
Women have small amounts of male hormones, and it is known that the female hormone estrogen helps prevent hair loss.
However, if the level of female hormones decreases for some reason, male hormones become relatively more dominant, leading to hair loss, which is called FAGA.
Reasons for the decrease in female hormones include aging, stress, and poor lifestyle habits. Although a certain amount of female hormones is always secreted, which prevents complete hair loss, FAGA has the following characteristics:
– Hair becomes thinner all over, not just in specific areas.
– Hair becomes finer.
– Thinning is most noticeable at the crown of the head.
Treatment: Medications such as minoxidil and spironolactone are recommended.
We offer both topical and oral treatments for FAGA!
Alopecia Areata
This condition causes hair to fall out in round patches on the scalp, and in severe cases, it can affect the entire scalp, eyebrows, eyelashes, and other body hair.
It is believed to be caused by an abnormality in the immune system, where T lymphocytes mistakenly attack hair follicles, considering them foreign substances, often triggered by physical or psychological stress.
Treatment: Recommended treatments include “steroid local injection therapy”, “topical immunotherapy”, “topical steroid therapy” and “wigs.”
Traction Alopecia
This type of hair loss occurs due to pulling on the hair.
It is caused by applying constant pressure on the same areas of the hair and scalp over a long period, often from hairstyles like tight ponytails that strain the hair follicles.
Treatment: Reviewing hairstyles and lifestyle habits.
Postpartum Alopecia
This is a type of hair loss that occurs after childbirth.
Due to hormonal fluctuations after childbirth, hair in the growth phase quickly transitions to the resting phase, leading to a sudden increase in hair shedding.
During pregnancy, the female hormone estrogen increases, extending the growth phase of the hair cycle and temporarily reducing hair shedding. However, after childbirth, the increased estrogen levels return to normal, causing hair that would have naturally shed during pregnancy to fall out all at once, resulting in noticeable thinning.
Treatment: It generally takes six months to a year for the hair cycle to return to its pre-pregnancy state. Additional tests may be conducted while monitoring the condition.
Treatment Methods for FAGA (Female Androgenetic Alopecia)
We provide treatment for FAGA, one of the four types of FPHL.
The common treatments for FAGA are minoxidil and spironolactone, both of which can be prescribed at the very day of your visit at our clinic.
Minoxidil is available in two forms: a topical solution applied directly to the scalp and an oral medication. It is used to treat both FAGA in women and AGA in men.
According to the 2017 guidelines for the treatment of male and female pattern hair loss, the recommended concentration of topical minoxidil for women is 1%.
Although this is lower than the 5% recommended for men, past studies have shown no significant difference in hair growth between those using 5% and 2% minoxidil, suggesting that higher concentrations are not necessary for treating FAGA in women.
Since oral minoxidil can cause body-wide hair growth as a side effect, we recommend starting with the topical solution.
Minoxidil can be used by both men and women, but it is not effective for hair loss due to pregnancy, chemotherapy, or scalp conditions that cause skin damage in women.
Product: Topical minoxidil solution 1% (Fuji Chemical Industries, Category 1 OTC drug)
Features: Female hair thinning and hair loss can be caused by aging, stress and lifestyle factors. Topical minoxidil for women helps promote hair growth and prevent hair loss progression, and is effective for mid-life hair loss.
Effects: It promotes the division of hair matrix cells, improves blood flow to the scalp, and nourishes hair matrix cells, making hair easier to grow.
Usage: Apply 1 ml twice daily to the thinning areas of the scalp.
Price (incl. tax):
1 month: 4,500 JPY
3 months: 12,000 JPY (4,000 JPY/month)
6 months: 22,000 JPY (3,667 JPY/month)
The side effects of topical minoxidil are as follows:
Reported side effects include initial hair shedding, scalp rash and skin reactions (redness, itching, irritation).
Some patients may experience increased hair shedding when starting treatment, known as “initial shedding”, which is a normal part of the process.
This phase involves shedding old hairs to make way for new, healthy hair, helping to normalize the hair cycle. Continue the medication as prescribed.
In rare cases, headaches, dizziness and swelling in the hands and feet may occur.
Severe side effects such as liver dysfunction have also been reported.
If you experience any abnormalities after application, consult your doctor.
Spironolactone is a medication traditionally used for hypertension, which also has anti-androgen effects.
AGA and FAGA are caused by the binding of the male hormone DHT (dihydrotestosterone) to androgen receptors in the scalp.
When DHT binds to these receptors, it inhibits the division of hair matrix cells in the frontal and vertex areas, shortening the growth phase of the hair cycle.
Spironolactone works by increasing urine output to eliminate excess salt and water, reducing swelling, and lowering blood pressure. It also has anti-androgen effects, making it useful for treating female hair thinning and acne.
– Those who want to lower their male hormone levels
– Adults suffering from acne, particularly those whose acne started or worsened in adulthood
– Those with extensive acne on their back or chest
– Those with mild to moderate hirsutism
– Those who did not see results from insured acne treatments
– Those with irregular menstrual cycles
Features: In addition to treating female hair thinning, it is used for acne and hirsutism. Gradually increasing the oral dosage allows for a manageable treatment plan.
Effects: The anti-androgen action prevents DHT (dihydrotestosterone), the cause of AGA/FAGA, from binding to androgen receptors in the scalp.
Price (incl. tax):
| Dosage | Price (JPY) (per 30 tablets) |
|---|---|
| 50mg | 3,000 |
| 100mg | 6,000 |
| 150mg | 9,000 |
| 200mg | 12,000 |
The side effects of spironolactone include the following:
We provide detailed instructions on proper usage whether it is for hormone replacement therapy or acne treatment.
Electrolyte imbalance (especially hyperkalemia), kidney dysfunction, low blood pressure, frequent urination, menstrual irregularities, abnormal bleeding and breast pain.
We regularly conduct blood tests to monitor for electrolyte imbalances and kidney dysfunction to ensure safe use.
Process of Prescription
The process for prescribing AGA medications at our clinic is as follows:
Immediate in-hospital prescription of AGA medications available.
For those using our teleprescription of PrEP/PEP, we can also ship AGA medications simultaneously.
Doctor’s Consultation and Examination
The doctor will discuss and determine the most suitable medication for you.
Prescription and Payment
At the reception, you will receive your FAGA medication. An initial consultation fee applies, but subsequent visits for prescription renewals do not require a consultation or fee.
Transgender Individuals and AGA
We are receiving an increasing number of inquiries about AGA from individuals undergoing male hormone therapy, particularly trans men.
Male hormone therapy can cause hair loss.
The effectiveness of AGA medications for hair loss due to male hormone therapy has been recognized by the World Professional Association for Transgender Health (WPATH).
We can also adjust or add spironolactone for individuals on female hormone therapy who are using topical or short-acting formulations.
Dr. Daisuke SHIOJIRI
Director of Personal Health Clinic, Doctor of Medicine. Providing medically accurate knowledge and compassionate care at National Center for Global Health and Medicine (Shinjuku, Tokyo) and Personal Health Clinic, focusing on STIs such as HIV and PrEP. Born in Japan and raised in Kenya, Africa, he is also licensed to practice in Kenya, where he participates in medical and educational support activities. He also serves as a visiting doctor at our clinic.
